CAJ | 학술논문

目的：探讨丝裂霉素C联合巩膜瓣可移动缝线治疗原发性青光眼的临床效果。方法按照手术方式不同将本院收治的120例原发性青光眼患者分为常规组40例、丝裂霉素C组40例和缝线组40例，常规组给予常规小梁切除术治疗，丝裂霉素C组术中应用丝裂霉素C的小梁切除术治疗，缝线组术中联合使用丝裂霉素C+巩膜瓣可移动缝线小梁切除术治疗，比较3组患者术前、术后第3天、术后1周、术后1个月、术后3个月和术后6个月的眼压变化，术后半年滤过泡情况、术后早期前房深度以及并发症发生情况。结果3组患者术后眼压均显著下降，与术前比较，差异有统计学意义(P<0.05)；丝裂霉素C组和缝线组患者术后不同时间眼压均显著低于常规组，差异有统计学意义(P<0.05)；丝裂霉素C组和缝线组患者功能性滤泡形成率均显著高于常规组，差异有统计学意义(P<0.05)；丝裂霉素C组患者术后早期Ⅰ、Ⅱ度浅前房发生率均显著高于常规组，差异有统计学意义(P<0.05)；缝线组患者术后早期Ⅰ、Ⅱ度浅前房发生率均显著低于丝裂霉素C组，差异有统计学意义(P<0.05)；3组均未出现角膜损伤、结膜瓣漏、黄斑水肿、眼内炎、恶性青光眼等并发症。丝裂霉素C组患者正常前房率显著低于常规组和缝线组，差异有统计学意义(P<0.05)。结论原发性青光眼术中丝裂霉素C联合巩膜瓣可移动缝线能显著提高手术的成功率，改善眼压，合理控制缝线的拆除数目及时间，临床应用和推广价值较高。
목적：탐토사렬매소C연합공막판가이동봉선치료원발성청광안적림상효과。방법안조수술방식불동장본원수치적120례원발성청광안환자분위상규조40례、사렬매소C조40례화봉선조40례，상규조급여상규소량절제술치료，사렬매소C조술중응용사렬매소C적소량절제술치료，봉선조술중연합사용사렬매소C+공막판가이동봉선소량절제술치료，비교3조환자술전、술후제3천、술후1주、술후1개월、술후3개월화술후6개월적안압변화，술후반년려과포정황、술후조기전방심도이급병발증발생정황。결과3조환자술후안압균현저하강，여술전비교，차이유통계학의의(P<0.05)；사렬매소C조화봉선조환자술후불동시간안압균현저저우상규조，차이유통계학의의(P<0.05)；사렬매소C조화봉선조환자공능성려포형성솔균현저고우상규조，차이유통계학의의(P<0.05)；사렬매소C조환자술후조기Ⅰ、Ⅱ도천전방발생솔균현저고우상규조，차이유통계학의의(P<0.05)；봉선조환자술후조기Ⅰ、Ⅱ도천전방발생솔균현저저우사렬매소C조，차이유통계학의의(P<0.05)；3조균미출현각막손상、결막판루、황반수종、안내염、악성청광안등병발증。사렬매소C조환자정상전방솔현저저우상규조화봉선조，차이유통계학의의(P<0.05)。결론원발성청광안술중사렬매소C연합공막판가이동봉선능현저제고수술적성공솔，개선안압，합리공제봉선적탁제수목급시간，림상응용화추엄개치교고。
Objective To explore the clinical effect of mitomycin-C combining with sclera flap movable suture in the operation of primary glaucoma. Methods According to different surgical methods,120 patients with primary glaucoma were evenly divided into regular group,mitomycin-C group and suture group.Conventional trabeculectomy was provided in the regular group.Mitomycin-C trabeculectomy was adopted in the mitomycin-C group.Trabeculectomy of mito-mycin-C with sclera flap movable suture was applied in the suture group.Changes of intraocular pressure before surgery,3 days,one week,one month,3 months,and 6 months after surgery,filtering bleb after half a year,postoperative chamber depth at an early stage,and complications were compared among 3 groups. Results IOP all greatly decreased after surgeries among 3 groups in comparison with that before surgery with statistical differences (P<0.05).In the mito-mycin-C group and suture group,IOP in different periods was lower than that in the regular group with statistical differ-ences (P<0.05).Formation rates of functional filtering blebs in the mitomycin-C group and suture group were both high-er than that in the regular group with statistical differences (P<0.05).Incidences of postoperative shallow anterior cham-berⅠ degree and II degree at early periods in the mitomycin-C group were both obviously higher than that in the regular group with statistical differences (P<0.05).Incidences of postoperative shallow anterior chamber Ⅰ degree andII degree at early periods in the suture group were both lower than that in the mitomycin-C group,which displayed sta-tistical significances (P<0.05). Conclusion In the operation of primary glaucoma,combination of mitomycin-C and scler-a flap movable suture can greatly increase operation success rate,improve IOP,and reasonably control the number and time of removed stitches,which has a higher value of clinical application and expansion.